The results of our survey of child vision screening services in England show a concerning rise in the number of local authorities not offering any form of reception-age screening.
Since 2019, when we last surveyed services across England, a further five local authorities have decommissioned child vision screening, meaning that 14 no longer offer this service, affecting around 75,000 reception-aged children every year. There is a risk this could result in visual defects in children going undetected and potentially becoming irreversible. In addition, undetected vision problems can prevent children from fully accessing their education
Equitable population vision screening, organised and led by an orthoptist, is recommended by the UK National Screening Committee and in the Public Health England guidance from 2017. Orthoptist-led child vision screening primarily aims to pick up Amblyopia, where the vision in one or both eyes doesn’t develop properly.
It is estimated that 1 in 50 children will develop this condition but it is rare for children to complain of poor vision, particularly if it only affects one eye, meaning this can easily go unnoticed. Reduced vision can have an impact on a child’s learning and development. Vision continues to develop in children until around eight years of age, therefore early detection and treatment helps avoid permanent visual impairment.
57%
of local authorities have orthoptic-led vision screening following PHE guidelines
33%
of local authorities have vision screening services that do not follow PHE guidelines (29%) or did not confirm whether or not they follow PHE guidelines (4%)
10%
of local authorities do not have any form of vision screening for 4-5 year olds
Of the 138 local authorities we received details on, 56.6% were covered by child vision screenings services that followed guidelines set out by Public Health England A further 33.3% of local authorities offered screening services that either did not follow these guidelines or we were not able to confirm whether they followed.
While the UK government, responsible for health policy in England, accepts the need for Orthoptic-led vision screening, they have not made this mandatory, unlike other forms of screening. This is in spite of the UK National Screening Committee of Public Health England recommending orthoptic-led screening for all 4-5 year olds.
This survey highlights the need for a nationwide mandatory orthoptic-led child vision screening programme. This would address the existing health inequalities in this vital area of a child’s development.
Fiona Bush, BIOS Public Health LeadThis has led to large inconsistencies in the availability of vision screening across England. Significant financial constraints and the lack of a mandate for vision screening has meant increasing numbers of local authorities decommissioning services. There is also some confusion as to who should be ensuring these services are provided.
As Health is devolved, the situation in Scotland, Wales and Northern Ireland is much more promising with all three countries offering nation wide programmes, demonstrating the feasibility of a nationwide approach.
Map showing child vision screening services decommissioned since 2020 (red), alongside services that did not exist in 2020 (pink)